Acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosis
Introduction and Objectives: AKI is known to be associated with increased risk of mortality, however limited information is available on how AKI impacts healthcare costs and resource utilization in hospitalized patients with cirrhosis. Previous studies have had variable definitions of AKI, resulting...
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| Format: | Article |
| Language: | English |
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Elsevier
2019-09-01
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| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119303473 |
| _version_ | 1818608213178712064 |
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| author | Raffi Karagozian Gaurav Bhardwaj Dorothy B. Wakefield Elizabeth C. Verna |
| author_facet | Raffi Karagozian Gaurav Bhardwaj Dorothy B. Wakefield Elizabeth C. Verna |
| author_sort | Raffi Karagozian |
| collection | DOAJ |
| description | Introduction and Objectives: AKI is known to be associated with increased risk of mortality, however limited information is available on how AKI impacts healthcare costs and resource utilization in hospitalized patients with cirrhosis. Previous studies have had variable definitions of AKI, resulting in inconsistent reporting of the true impact of AKI in patients with cirrhosis. Methods: Data from the Nationwide Inpatient Sample (NIS) which contains data from 44 states and 4378 hospitals, accounting for over 7 million discharges were analyzed. The inclusion data were all discharges in the 2012 NIS dataset with a discharge diagnosis of cirrhosis. Results: A total of 32,605 patients were included in the analysis, incidence of AKI was 12.12% in patients with cirrhosis. Crude mortality was much higher for patients with cirrhosis and AKI (14.9% vs. 1.8%, OR 9.42, p < 0.001) than for patients without AKI. In addition, mean LOS was longer (8.5 vs. 4.3 days, p < 0.001) and median total hospital charges were higher for patients with AKI ($43,939 vs. $22,270, p < 0.001). In multivariate logistic regression, controlling for covariates and mortality risk score, sepsis, ascites and SBP were predictors of AKI. Conclusions: AKI is relatively common in hospitalized patients with cirrhosis. Presence of AKI results in significantly higher inpatient mortality as well as LOS and resource utilization. Median hospitalization cost was twice as high in AKI patients. Early identification of patients at high risk for AKI should be implemented to reduce mortality and contain costs. Prognosis could be enhanced by utilizing biomarkers which could rapidly detect AKI. |
| first_indexed | 2024-12-16T14:39:04Z |
| format | Article |
| id | doaj.art-30a013d8a22e4edf826cebb6034e566b |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-12-16T14:39:04Z |
| publishDate | 2019-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-30a013d8a22e4edf826cebb6034e566b2022-12-21T22:28:01ZengElsevierAnnals of Hepatology1665-26812019-09-01185730735Acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosisRaffi Karagozian0Gaurav Bhardwaj1Dorothy B. Wakefield2Elizabeth C. Verna3Tufts Medical Center, Tufts University School of Medicine, Boston, MA, United States; Corresponding author at: Tufts Medical Center Division of Gastroenterology & Hepatology, Tufts University School of Medicine, 800 Washington St, Box #233, Boston, MA 02111, United StatesMontefiore Medical Center, Albert Einstein College of Medicine, Bronx, NYCenter for Public Health and Health Policy, UConn Health, Farmington, CT, United States; St Francis Hospital & Medical Center, Hartford, CT, United StatesNew York Presbyterian-Columbia University Medical Center, New York, NY, United StatesIntroduction and Objectives: AKI is known to be associated with increased risk of mortality, however limited information is available on how AKI impacts healthcare costs and resource utilization in hospitalized patients with cirrhosis. Previous studies have had variable definitions of AKI, resulting in inconsistent reporting of the true impact of AKI in patients with cirrhosis. Methods: Data from the Nationwide Inpatient Sample (NIS) which contains data from 44 states and 4378 hospitals, accounting for over 7 million discharges were analyzed. The inclusion data were all discharges in the 2012 NIS dataset with a discharge diagnosis of cirrhosis. Results: A total of 32,605 patients were included in the analysis, incidence of AKI was 12.12% in patients with cirrhosis. Crude mortality was much higher for patients with cirrhosis and AKI (14.9% vs. 1.8%, OR 9.42, p < 0.001) than for patients without AKI. In addition, mean LOS was longer (8.5 vs. 4.3 days, p < 0.001) and median total hospital charges were higher for patients with AKI ($43,939 vs. $22,270, p < 0.001). In multivariate logistic regression, controlling for covariates and mortality risk score, sepsis, ascites and SBP were predictors of AKI. Conclusions: AKI is relatively common in hospitalized patients with cirrhosis. Presence of AKI results in significantly higher inpatient mortality as well as LOS and resource utilization. Median hospitalization cost was twice as high in AKI patients. Early identification of patients at high risk for AKI should be implemented to reduce mortality and contain costs. Prognosis could be enhanced by utilizing biomarkers which could rapidly detect AKI.http://www.sciencedirect.com/science/article/pii/S1665268119303473Length of stayNational inpatient sampleMortalityICD-9Hospital charges |
| spellingShingle | Raffi Karagozian Gaurav Bhardwaj Dorothy B. Wakefield Elizabeth C. Verna Acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosis Annals of Hepatology Length of stay National inpatient sample Mortality ICD-9 Hospital charges |
| title | Acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosis |
| title_full | Acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosis |
| title_fullStr | Acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosis |
| title_full_unstemmed | Acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosis |
| title_short | Acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosis |
| title_sort | acute kidney injury is associated with higher mortality and healthcare costs in hospitalized patients with cirrhosis |
| topic | Length of stay National inpatient sample Mortality ICD-9 Hospital charges |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119303473 |
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